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Hi everyone! Today’s post is a juicy one. A peek into the finances of a total stranger, yay! God bless the internet for making these things possible.

(But wait, before we get to the good stuff, I need to share something with you, internet friends. I started the process of house hunting! It’s exactly like you see on HGTV, except 800% less glamorous. Shag carpet and wood paneling, anyone? Pink bathtubs? Furnaces from 1957? I’m so excited! And mildly terrified. Is this #adulting? I’ll keep you updated on my progress!)

In Integrative Practice Management, it’s standard to have each student create a projected outline of their practice startup costs, based on the kind of practice they plan to have, their location, cost of rent/living in that area, etc.

(If your acupuncture school doesn’t make you do this as a student, that’s crazy sauce. You MUST. It is essential to have a plan, or you’ll risk wasting money and floundering in the dark. Use my Acupuncture Startup Cost Worksheet [click below] at the very least, and then ask one of your acupuncture professors to give you feedback on it. Do not graduate without doing this.)

After asking the students to complete their project startup costs budget, they were curious about what a real person actually spent to start a practice. As an over-sharer, I was happy to volunteer that information for them.

You guys know I’m always encouraging students and practitioners alike to learn from the experience of those who have gone before them.

I’m like a broken record, but I’ll say it again: as a group, acupuncturists have a wealth of knowledge and experience about practice building that we can share with others to help everyone succeed. The more we share, the better off our profession is as a whole, and that’s win-win.

So I thought it would be beneficial to share my startup costs here on Modern Acupuncture Marketing, for any students out there who are about to get started. I also think it’s interesting for established practitioners to see how others began their businesses, if for nothing else than curiosity’s sake. The internet thrives on sneaking a peek into the lives of total strangers, right? I’m all for that ??

Before I give you my budget, let me outline my personal philosophy on acupuncture practice startup costs. I think this is important.

In a word: Minimalism.

I always encourage the acupuncture students at FLSAOM to start small. I don’t understand why sometimes people think they need thousands of dollars or a huge business loan to fit out a whole office or multi-room space. I suppose it depends on your future plans and ambitions. But if you have no patients at first, why do you need to rent several rooms or an entire building?

(And yes, I have heard of real students who graduated, rented entire buildings with multiple treatment rooms, and then wondered aloud why they struggled to pay rent. It’s because you’re paying for more space than you need, or can possibly fill at that point.)

I’ve heard it suggested by other practice management professionals (not naming names) that you should set up your “ideal office” right after graduation, with the number of treatment rooms you ultimately imagine using once you’re “successful.” I suppose this is what the students that I mentioned above did, who wondered eventually why they couldn’t pay rent.

I personally think this is terrible advice. Then you have to pay to fill a reception area and multiple rooms with furniture, treatment equipment, acupuncture supplies, plus pay rent and utilities on a larger space. Yet you have no patients to fill those treatment rooms. This feels backwards to me, and I disagree with it. (If you disagree with me, let me know in the comments. I’m interested to hear your opinions.)

My personal philosophy is to start small and expand into a larger space as you grow.

So obviously I made a huge effort to keep my personal budget very low when I first started. I’m a minimalist in many areas of my life (hello, only eight outfits in my closet!), so starting my practice was no different. I knew how much money I had to spend and had no intention of going into more debt to get my practice rolling.

Now, I know minimalism isn’t for everyone. Perhaps if you have different goals or ambitions, or a family, or more or less student loan debt, or a hefty savings account, or whatever your case may be, you’ll be inclined to set up your practice differently. All I’m suggesting is that you consider minimalism as a viable possibility, because it certainly worked for my practice.

You can upgrade to fun, cool stuff later on, when you have an actual income. In the first year of practice, your income can be very variable while you’re building. This variability can be stressful. The lower your startup costs are, the more cash you could theoretically have on hand for unexpected expenses in your practice (or in your life).

Why make your life more stressful than it has to be by overspending and taxing your budget from the very beginning?

So I’m just sayin’… this is my advice. Fit it into your life as you see fit.

Finally, the details…

For reference, when I started it was January 2011 and I was renting a single room in a wellness center in a suburb of Rochester, New York. The reception area was taken care of by the wellness center; I did not have to contribute anything (money, furniture, etc.) for that. I already had a laptop, and they had a printer in the reception area that I was allowed to use, included in my rent.

Total: $1738

A few considerations:

You’ll notice I didn’t use software for my patient notes. Patient management software was just becoming a “thing” in 2010 when I started, and I didn’t feel like I needed it. I also have an affinity for writing on paper (I’m sorry, trees ?). If that’s something you feel like you must have (and the laws about keeping medical records may dictate it eventually), then budget for it. The cost of electronic medical records software can range widely, from about $45 to $100 per month.

I also didn’t start out with an online schedule (like Schedulicity or Genbooks) because that wasn’t really a thing yet either. Online scheduling also ranges in price, depending on the features, but I think $20 or $30 per month is fairly average. And sometimes the patient management software above actually has an online schedule feature built-in. Even though an online schedule may make your life easier and be “the thing to do,” it is technically optional when you’re first starting out.

I would also challenge you to really consider whether you need an Earthlite table. It’s “the brand” to have but since graduating I’ve discovered other, less expensive, perfectly good brands for $200-ish. We have Earthlites here at FLSAOM, so I think our students automatically decide to get an Earthlite without checking other prices. But there are many options out there, at many price points.

And I chose a DBA over an LLC because I had no possessions (home, etc.) to protect or family to worry about in case of litigation. (Check out this awesome free course from AcuProsper about the differences between a DBA, LLC, and PLLC.) An LLC or PLLC is more expensive than a DBA, and costs can vary state by state. Check your state’s “Department of State, Division of Corporations, State Records” (at least that’s what it’s called in New York) for more info.

Later on, when I felt financially comfortable, I eventually purchased a TDP heat lamp for about $120, a table warmer for around $45, and much later, a nicer Earthlite table (i.e, not the folding travel model) for about $450. (Which felt pretty baller, I must admit.) And later still, I opened a second office space in another town and spent the money to fit out that treatment room as well.

All of these costs and considerations (and many others) are included in the free worksheets below. I laid it all out there: all the various things you could potentially purchase to get your practice started. The idea is to choose what you feel you need.

I also added a section on projecting your monthly expenses, because this is as important as preparing for your initial startup costs. If you notice that I forgot anything, leave a message in the comments below so I can add it!

Download the free Acupuncture Practice Startup Costs Workbook:

Please let me know what you think of the workbook.For established practitioners, if you have advice or anything to add to the worksheets, please leave comments below. It’s so important that we make an effort to share what we’ve learned through experience so everyone can be successful and our profession can grow as a whole.

Share your practice startup costs in the comments below. I would love to see them.The more examples students can read about the different ways people started their businesses, the better informed they can be in their early practice decisions. Our transparency is essential in helping others build their own success. I hope you’ll volunteer your startup costs in the comments.

Or if, you’d like to be interviewed anonymously in order to share your startup expenses, please shoot me an email at ModernAcu@gmail.com – I want to hear from you!

Reader Interactions

Comments

Hi Isang, so glad you found it helpful! That really makes my day 🙂 Thank you for the feedback. Feel free to email me to let me know what other topics you’d like to see on Modern Acupuncture 🙂 ModernAcu@gmail.com

Great advice! I’m in my second year of practicing and I’ve told several students to rent a room from someone first! Do not take on the responsibility of having your own office during the first year. I just opened my own office and 70% of everything I’ve purchased is used. I bought items from Craigslist, Goodwill, and the clearance isle. I planned months ahead of time and bargain shopped which allowed me to pick up decorative items for as low as $5; my office is beautifully decorated on a budget!

Hi Linyana! Thanks so much for commenting. I’m glad to hear that you give students similar advice – it’s nice to know that other people agree with my perspective and I’m not giving advice in a vacuum. And I totally agree about getting most of your office furniture used. I think there is a such a huge temptation to buy everything new because we want to feel like we’ve finally “made it” or we feel like our practice is “less than” if we don’t make a fresh start with shiny new things. You’re right though, buying used does often takes advance planning, and many people don’t want to put that kind of effort in. Which is a shame because it can really help control your budget!

I have heard that moving locations to “grow” that you loose patients and are starting fresh anyway. That if you are to build a business it is best to do it at your final location. This is a good plan.

After interviewing other acupuncturists who’ve experienced a loss of retention when moving I am convinced that that plan can work. Go big.

I have also interviewed acupuncturists who’ve had great retention. I noticed a difference immediately: It seems to boil down to how well they’ve specialized with thier practice.

Generalists seem to have worse retention upon moving. Specialists seem to have better. Why? Who knows. Maybe a better relationship with the patient’s condition?

Now this is all totally anecdotal. But if you are to specialize, it makes sense to start small, at least.

My initial business plan was to go big. But I’ve concluded after some cups of coffee (and beer) with acupuncturists to instead go small.

If I want to spend more moneyso badly I can apply it towards promoting my business instead of paying for rent.

Though, yet to build my business, I still have quite a bit of doubt that I will have enough of the exposure needed to grow. One acupuncturist I asked, “do you have any regrets?” The answer was affirmative: “I started out too small in too obscure of a location. I would have loved having a sign or something.” He makes $800 a month. I worry about that sometimes.

Again even his case is anecdotal, maybe he’s blaming his lack of success on signage.

That begs the question: is launching small the fear of failure or a genuinely viable plan for being efficient and effective?

Hi Adrian, thanks for commenting! Oh man, these are some great questions and could probably be a blog post in itself! I love that you’re interviewing multiple acupuncturists to find out how they got started and what factors have influenced their success or lack thereof. I think just from the initiative you show in doing that, you’re going to be successful. I also agree with your statement, “If I want to spend more money so badly I can apply it towards promoting my business instead of paying for rent.” If your practice is explosive and you need to expand, you can expand. But that’s just my opinion – you know from this post that I prefer a minimalist, start-small-then-grow approach. For the acupuncturist who only makes $800 a month, I think there might be many factors that you didn’t discuss with him that could be resulting in his $800/month income. Lack of signage could certainly a possibility. People need to know your practice exists, and if a sign would help, then why on earth wouldn’t you a sign? And location can really be everything; to prevent renting a space in a location that you regret, I would ask local people for their opinion about the traffic (car and foot traffic) in the area as well as whether they consider it an “interesting” or “nice” part of town – ie, does anybody actually spend time in that part of town? Is it considered safe? Etc. Plus, perhaps you could interview that acupuncturist again and ask him what kind of marketing, networking, free educational presentations, etc. he did to try to increase people’s awareness of his practice, even though the location was difficult. For your last question, “Is launching small the fear of failure or a genuinely viable plan for being efficient and effective?” Great question. My answer would be no – it’s absolutely not about fear of failure. For me, at least. Perhaps for some it is? But I believe strongly that if you have hardly any patients (and it does take time to grow your patient base), why pay rent and utilities on a large, multi-room space? That doesn’t make sense to me, to spend money on a large space when you don’t have patients to fill the space. You can move to a larger space later on. And I don’t think a fear of moving to a new location is entirely justified, if you do it right. If you can move just a few streets over, then I don’t think you lose too many patients. It also depends on how you advertise the move to your patients (how far in advance, etc.). Great questions, Adrian! I really appreciate that you commented. Keep ’em coming!

Thanks for putting this all together! I was recently lit up by my first series of acupuncture appointments (helped relieve persistent shoulder/neck stiffness from bike commuting, as well as some persistent face acne related to digestive issues, kidney yang deficiency?) and am now actively compiling scholarship info and business plans as I prepare to apply to Northwestern’s Oriental Medicine & Acupuncture Degree program. I look forward to reading through more of your posts!

Hi Tom, so glad to hear that you had such a great experience with your first series of treatments and that you’re planning to apply to acupuncture school! That’s something I absolutely love to hear 🙂 I considered applying to Northwestern but didn’t end up going there because of the distance (I live in New York). But I’ve heard good things about their program. Are you planning to study herbal medicine as well as acupuncture?

Pretty darn useful info…add this to the list of things I wish ANYONE had talked about when I was in school.

I do think there are a few things that are missing from this list- #1 being herbs! Most of my colleagues seem like they either got a job at an existing clinic or get patents as they need them. I don’t know anyone who is doing custom herbs right out of school but it’s really a priority for me, especially after working on ships with only 8 formulas at my disposal. Honora Lee Wolfe has a great book on getting started with your own pharmacy that I highly recommend. It DOES take a little money but at least my community seems super interested, I hope to make it back quickly.

Also I didn’t see any costs of things like a printer/printing (easy to get a printer cheap off craigslist etc, but you still need to get paper and ink…some bulk paperwork it is probably cheaper to have printed at a copy shop). I think it’s probably cheaper to go with paper in the beginning rather than electronic which is still expensive.

Definitely look out for sales- I got the acupuncture supplies at Lhasa OMS’ annual holiday sale 15% off…the herbs were purchased from 3 companies on 20% off deals. Overall I think your number is pretty accurate because even with getting a basic pharmacy started (I tincture from granules and got a couple patents) I’m still at about $2k. If you would like to have the list I have a spreadsheet.